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Abstract

Rheumatoid arthritis is a systemic disease characterized by pain and disability in peripheral joints. The disease may affect any organ but exhibits a strong preference for tissues abundant in mucopolysaccharide as, for example, the joints, other serous surfaces, the eye, and the arteries. Although etiology remains obscure, immune responses may be important. The most typical histologic lesion is the necrobiotic granuloma. This is an inflammatory mass with a central zone of necrosis surrounded by a fibrous layer of palisaded connective-tissue cells in a matrix containing scattered chronic inflammatory cells such as lymphocytes, plasma cells, and histiocytes. This histologic lesion is